Daniil A. Sergeev

Background. Onychomycosis is significant in patients with diabetes mellitus (DM), but its diagnosis is complicated due to its clinical resemblance to onychodystrophies. Objective. To evaluate the potential of PCR testing for the diagnosis of onychomycosis in patients with DM. Material and methods. The study included 46 patients: 17 (37.0%) men, 29 (63.0%) women; age 66.5 [54.5; 71.0] years. The patients were evaluated for nail changes (SCIO index), skin condition of the feet, and nail scraping results from KOH microscopy and PCR for Microsporum canis, Microsporum gypseum, Trichophyton spp., Epidermophyton floccosum, Trichophyton rubrum, Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus terreus, and Candida albicans. Results. Changes in nails were recorded in 26 (56.5%) patients, and in the foot skin in 29 (63.0%) subjects, 26 of whom presented with plantar scaling. In case of nail changes, the SCIO scores were distributed as follows: 16—30 points in 10 patients, 6—10 points in 8, 2—5 points in 5, and 11—15 points in 3. Onychomycosis was detected in 18 (39.1%) patients, a positive KOH microscopy result was obtained in 16 cases, and PCR was identified in 10 patients (DNA of Trichophyton spp. — 7 cases, Trichophyton rubrum — 4, Candida albicans — 3, Aspergillus niger — 1). All patients with positive PCR results were aged over 60 years, had type 2 DM and presented with foot skin changes. Conclusion. In DM, nail changes were more common (56.5% of patients) than onychomycosis (39.1%). Pathogenic fungi were detected by PCR in 21.7% of cases, increasing microscopy results by 10%. This demonstrates both the feasibility of PCR and the need to expand PCR diagnostic panels, given that the pathogen could not be identified by PCR in 8 out of 16 microscopy-positive patients.

Childhood obesity is crucial medical and social issue due to development of metabolic complications, chronic low-grade inflammation, and insulin resistance as the key factor of metabolic syndrome. Thus, the search of safe and effective methods for prevention and management of childhood obesity remains relevant. The efficacy of obesity complex therapy can be enhanced via nutraceuticals — dietary supplements with established positive effect on health. This review analyzes wide range of nutraceuticals (omega 3 fatty acids, probiotics, inositols, berberine, diindolylmethane, etc.), their mode of action, efficacy and safety indicators, and administration features.

This review presents current data on the pharmacokinetics, side effects, dosage forms and interactions of curcumin. Curcumin, the major bioactive component of turmeric, has low bioavailability due to its low water solubility, rapid metabolism in the liver and rapid excretion from the body. The main pathways of curcumin metabolism are described, including its reduction and subsequent conjugation with glucuronic acid and sulphates. Side effects of curcumin such as hyperoxaluria, iron deficiency anaemia, hepatotoxicity, arrhythmias, allergic reactions and potential carcinogenic properties are discussed. Various dosage forms of curcumin developed to enhance its bioavailability are discussed, including liposomes, nanoparticles, hydrogels and phytosomes. Particular attention is given to the drug interactions of curcumin with chemotherapeutic agents such as 5-fluorouracil, vincristine, gemcitabine, adriamycin and cisplatin, as well as with hypolipidaemic agents, antiaggregants and anticoagulants. These data highlight the need for further studies to optimise the therapeutic use of curcumin and minimise its side effects.

Curcumin, an active ingredient derived from turmeric root (Curcuma longa), has significant pharmacological properties including anti-inflammatory, antioxidant, antimicrobial, anticancer and analgesic activities. Studies show that curcumin affects the expression of various microRNAs and long non-coding RNAs to regulate cell proliferation and apoptosis in various types of malignant tumours. In addition, curcumin modulates signalling pathways such as PI3K/Akt/mTOR, MAPK/ERK and AMPK, activating autophagy and inhibiting tumour angiogenesis. It also inhibits metastasis and invasion of tumour cells by affecting epithelial-mesenchymal transition and expression of matrix metalloproteinases. Curcumin exhibits antibacterial and antiviral activity by disrupting bacterial cell membranes and inhibiting viral replication. The antioxidant properties of curcumin are due to its ability to neutralise reactive oxygen species and stimulate antioxidant enzymes. Curcumin also promotes wound healing by modulating inflammatory processes and stimulating angiogenesis. The analgesic effect of curcumin is due to its ability to stimulate the release of endogenous opioid peptides and modulate the activity of GABA receptors and ASIC and TRPV ion channels. Curcumin has an effect on lipid and carbohydrate metabolism, which makes it a promising agent for the treatment of dyslipidaemia and insulin resistance. The effect of curcumin on haemostasis is manifested in its ability to inhibit platelet aggregation and blood clotting, which may be useful for the prevention of cardiovascular diseases.

This review examines modern approaches to the diagnosis and treatment of irritable bowel syndrome (IBS) in children, one of the most common functional disorders of the gastrointestinal tract. IBS is characterized by chronic abdominal pain, intestinal motility disorders and stool changes, which significantly reduces the quality of life of patients. The article analyzes in detail the pathogenetic mechanisms of IBS, including the role of the gut–brain axis, gut microbiota and neuroendocrine factors. Special attention is paid to the pharmacotherapy of IBS in children, including the use of antidepressants, probiotics and herbal components, as well as the role of correctors of the motor activity of the digestive tract in relieving symptoms. Modern recommendations on the use of various classes of antidepressants are considered, taking into account their pharmacokinetic and pharmacodynamic characteristics. The prospects of using probiotics and herbal preparations in the complex therapy of IBS are also analyzed. The data obtained confirm the need for a personalized approach to the treatment of IBS, taking into account the genetic and physiological characteristics of patients.